Invoice Detail: # 21022
- Invoice Date
- 05/31/2023
- Customer Name
- Sylvia Smilen Trust
- Statement Note
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Invoice # 1092 (Old Invoice # system). Customer Sylvia Smilen Trust: Rate = 17.00/hr. Mrs. Sherman: Submitted this to JH for Claim #: R12 004 977 via fax @800.638.4040 on June 12, 2023@8:27AM. Successful fax confirmation June 12, 2023@8:42AM
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Date Task Description Units Total 05/03/2023 Standing Unit of Care for Sylvia Smilen/hr. 05/03/2023 Care: 3:00PM-9:00PM 6.00 102.00 05/05/2023 Standing Unit of Care for Sylvia Smilen/hr. 05/05/2023 Care: 3:00PM-9:00PM 6.00 102.00 05/10/2023 Standing Unit of Care for Sylvia Smilen/hr. 05/10/2023 Care: 3:00PM-9:00PM 6.00 102.00 05/12/2023 Standing Unit of Care for Sylvia Smilen/hr. 05/12/2023 Care: 1:00PM-9:00PM 8.00 136.00 05/17/2023 Standing Unit of Care for Sylvia Smilen/hr. 05/17/2023 Care: 1:00PM-9:00PM 8.00 136.00 05/19/2023 Standing Unit of Care for Sylvia Smilen/hr. 05/19/2023 Care: 1:00PM-9:00PM 8.00 136.00 05/24/2023 Standing Unit of Care for Sylvia Smilen/hr. 05/24/2023 Care: 1:00PM-9:00PM 8.00 136.00 05/26/2023 Standing Unit of Care for Sylvia Smilen/hr. 05/26/2023 Care: 1:00PM-9:00PM 8.00 136.00 05/31/2023 Standing Unit of Care for Sylvia Smilen/hr. 05/31/2023 Care: 1:00PM-9:00PM 8.00 136.00 Invoice Totals: 66.00 $1,122.00 Invoice #21022 was created on Wednesday, May 31, 2023
Source Document: Local Storage: Source Docs\John Hancock\JHLTC_DocScan_20230605.pdf;Local Storage: Source Docs\John Hancock\Confirmation_JHLTC_DocScan_20230605_Fax.pdf